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ACE, ARBs and heart and kidney

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https://www.readbyqxmd.com/read/29898489/-ace-inhibitors-and-arb-in-chronic-kidney-disease-what-has-to-be-considered
#1
Martin Zeier
Proteinuric kidney disease, especially in the early and middle stages of renal insufficiency, may be favorably affected by ACE-I/ARB. The progression of renal insufficiency is thereby slowed down and dialysis obligation occurs later or can even be avoided. This effect is independent of the underlying glomerular kidney disease. In the advanced stage of renal insufficiency, the benefit of ACE-I/ARB cannot yet be conclusively assessed. The interruption of ACE-I/ARB therapy may possibly contribute to a certain recovery of renal function and delay the onset of dialysis a little...
June 2018: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/29786183/-hyperkalemia-as-a-limiting-factor-in-the-use-of-drugs-that-block-the-renin-angiotensin-aldosterone-system-raas
#2
Antonio Santoro, Marcora Mandreoli
Angiotensin-converting enzyme (ACE-I) inhibitors and ARBs have shown real efficacy in reducing blood pressure, proteinuria, in slowing the progression of chronic kidney disease (MRC) and in clinical improvement. in patients with heart failure, diabetes mellitus and ischemic heart disease. However, their use is limited by some side effects such as the increase in serum potassium (K), which can be particularly severe in patients with renal insufficiency. In the 23,000 patients followed by the PIRP project of the Emilia-Romagna Region, hyperkalaemia at the first visit (K> 5...
May 2018: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/29767459/long-term-effects-of-patiromer-for-hyperkalaemia-treatment-in-patients-with-mild-heart-failure-and-diabetic-nephropathy-on-angiotensin-converting-enzymes-angiotensin-receptor-blockers-results-from-amethyst-dn
#3
Bertram Pitt, George L Bakris, Matthew R Weir, Mason W Freeman, Mitja Lainscak, Martha R Mayo, Dahlia Garza, Rezi Zawadzki, Lance Berman, David A Bushinsky
AIMS: Chronic kidney disease (CKD) in heart failure (HF) increases the risk of hyperkalaemia (HK), limiting angiotensin-converting enzyme inhibitor (ACE-I) or angiotensin receptor blocker (ARB) use. Patiromer is a sodium-free, non-absorbed potassium binder approved for HK treatment. We retrospectively evaluated patiromer's long-term safety and efficacy in HF patients from AMETHYST-DN. METHODS AND RESULTS: Patients with Type 2 diabetes, CKD, and HK [baseline serum potassium >5...
May 16, 2018: ESC Heart Failure
https://www.readbyqxmd.com/read/29726982/a-real-world-cohort-study-on-the-quality-of-potassium-and-creatinine-monitoring-during-initiation-of-mineralocorticoid-receptor-antagonists-in-patients-with-heart-failure
#4
Erik Nilsson, Pietro De Deco, Marco Trevisan, Rino Bellocco, Bengt Lindholm, Lars H Lund, Josef Coresh, Juan J Carrero
AIMS: Clinical heart failure (HF) guidelines recommend monitoring of creatinine and potassium throughout the initial weeks of mineralocorticoid receptor antagonists (MRAs) therapy. We here assessed the extent to which this occurs in our healthcare. METHODS AND RESULTS: Observational study in 2007-2010 HF patients starting MRA therapy in Stockholm, Sweden. Outcomes included potassium and creatinine laboratory testing before MRA initiation and in the early (days 1-10) and extended (days 11-90) post-initiation periods...
May 2, 2018: European Heart Journal. Quality of Care & Clinical Outcomes
https://www.readbyqxmd.com/read/29381513/a-systematic-review-of-outcomes-associated-with-withholding-or-continuing-angiotensin-converting-enzyme-inhibitors-and-angiotensin-receptor-blockers-before-noncardiac-surgery
#5
Caryl Hollmann, Nicole L Fernandes, Bruce M Biccard
BACKGROUND: The global rate of major noncardiac surgical procedures is increasing annually, and of those patients presenting for surgery, increasing numbers are taking either an angiotensin-converting enzyme inhibitor (ACE-I) or an angiotensin receptor blocker (ARB). The current recommendations of whether to continue or withhold ACE-I and ARB in the perioperative period are conflicting. Previous meta-analyses have linked preoperative ACE-I/ARB therapy to the increased incidence of postinduction hypotension; however, they have failed to correlate this with adverse patient outcomes...
January 29, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29374813/dynamic-tissue-perfusion-assessment-reflects-associations-between-antihypertensive-treatment-and-renal-cortical-perfusion-in-patients-with-chronic-kidney-disease-and-hypertension
#6
Arkadiusz Lubas, Grzegorz Kade, Marek Saracyn, Stanisław Niemczyk, Przemysław Dyrla
PURPOSE: Renal cortical perfusion measured in noninvasive, dynamic ultrasonic method is connected with the hemodynamic cardiac properties and renal function. Antihypertensive drugs affect the functioning of the heart and kidneys. The aim of the study was to evaluate the effect of a chronic use of antihypertensive drugs on ultrasound parameters of renal cortical perfusion. METHODS: The study included 56 consecutive patients (49 M + 7 F, age 54.0 ± 13.3) with stable chronic kidney disease and hypertension...
March 2018: International Urology and Nephrology
https://www.readbyqxmd.com/read/29374807/the-sacubitril-valsartan-a-first-in-class-angiotensin-receptor-neprilysin-inhibitor-arni-potential-uses-in-hypertension-heart-failure-and-beyond
#7
REVIEW
Kazuomi Kario
PURPOSE OF REVIEW: Sacubitril/valsartan (LCZ696) is a first-in-class, novel-acting, angiotensin receptor neprilysin inhibitor (ARNI) that provides inhibition of neprilysin and the angiotensin (AT1 ) receptor. A recent clinical trial PRARDIGM-HF demonstrated that this drug is superior to angiotensin-converting enzyme (ACE) inhibitors for improving the prognosis in the patients with heart failure, and this has resulted in the drug being included in clinical practice guidelines for the management of heart failure with reduced ejection fraction (EF)...
January 27, 2018: Current Cardiology Reports
https://www.readbyqxmd.com/read/29105751/real-life-use-of-neurohormonal-antagonists-and-loop-diuretics-in-chronic-heart-failure-analysis-of-serial-biomarker-measurements-and-clinical-outcome
#8
Milos Brankovic, K Martijn Akkerhuis, Nick van Boven, Olivier Manintveld, Tjeerd Germans, Jasper Brugts, Kadir Caliskan, Victor Umans, Alina Constantinescu, Isabella Kardys
We determined the temporal effects of neurohormonal antagonists and loop diuretics on serially assessed (3-monthly) cardiorenal biomarkers, functional status, and clinical outcomes in 250 patients with chronic heart failure (CHF) with reduced ejection fraction. In blood, we measured NT-proBNP, troponin T, C-reactive protein, creatinine, cystatin C; in urine, N-acetyl-beta-d-glucosaminidase and kidney-injury-molecule-1. Angiotensin converting enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARBs) were inversely associated with cardiac impairment, inflammation, and renal tubular damage, but not with glomerular dysfunction...
November 6, 2017: Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28873219/treatment-effectiveness-in-heart-failure-with-comorbidity-lung-disease-and-kidney-disease
#9
Jerry H Gurwitz, David J Magid, David H Smith, Grace H Tabada, Sue Hee Sung, Larry A Allen, David D McManus, Robert J Goldberg, Mayra Tisminetzky, Alan S Go
OBJECTIVES: To assess the clinical effectiveness of beta-blocker therapy in individuals with heart failure (HF) and chronic lung disease and of angiotensin-converting enzyme inhibitors (ACE-Is) and angiotensin II receptor blockers (ARBs) in individuals with HF and chronic kidney disease. DESIGN: Retrospective cohort study. SETTING: Community. PARTICIPANTS: Individuals with HF with reduced ejection fraction (HFrEF) or HF with preserved ejection fraction (HFpEF)...
December 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28724651/hyperkalemia-after-initiating-renin-angiotensin-system-blockade-the-stockholm-creatinine-measurements-scream-project
#10
Ghassan Bandak, Yingying Sang, Alessandro Gasparini, Alex R Chang, Shoshana H Ballew, Marie Evans, Johan Arnlov, Lars H Lund, Lesley A Inker, Josef Coresh, Juan-Jesus Carrero, Morgan E Grams
BACKGROUND: Concerns about hyperkalemia limit the use of angiotensin-converting enzyme inhibitors (ACE-I) and angiotensin receptor blockers (ARBs), but guidelines conflict regarding potassium-monitoring protocols. We quantified hyperkalemia monitoring and risks after ACE-I/ARB initiation and developed and validated a hyperkalemia susceptibility score. METHODS AND RESULTS: We evaluated 69 426 new users of ACE-I/ARB therapy in the Stockholm Creatinine Measurements (SCREAM) project with medication initiation from January 1, 2007 to December 31, 2010, and follow-up for 1 year thereafter...
July 19, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28666408/effects-of-angiotensin-converting-enzyme-inhibitors-and-angiotensin-receptor-blockers-on-cardiovascular-events-and-residual-renal-function-in-dialysis-patients-a-meta-analysis-of-randomised-controlled-trials
#11
REVIEW
Youxia Liu, Xinxin Ma, Jie Zheng, Junya Jia, Tiekun Yan
BACKGROUND: The role of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) reducing risk of cardiovascular events (CVEs) and preserving kidney function in patients with chronic kidney disease is well-documented. However, the efficacy and safety of these agents in dialysis patients is still a controversial issue. METHODS: We systematically searched MEDLINE, Embase, Cochrane Library and Wanfang for randomized trials. The relative risk (RR) reductions were calculated with a random-effects model...
June 30, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28177101/-severe-hyperkalemia-in-patients-referred-to-an-emergency-departement-the-role-of-antialdosterone-drugs-and-of-renin-angiotensin-system-blockers
#12
Daria Motta, Giulio Cesano, Angelo Pignataro, Roberto Boero
We analyzed the clinical features and the factors associated with the presence of hyperkalemia (serum potassium >5.3 mmol/L) in a cohort of patients presenting to an Emergency Department. A total of 168 cases were observed (89 males and 79 females), mean age 77.512 years. Fifty-six patients were diabetics (33.3%), 51 patients had chronic kidney disease (30%) and 36 patients with cardiac failure (21.4%). Sixty-nine patients (41%) were treated with RAS-blockers (ACE-I n = 50; ARBs, n = 19). 65 subjects were taking loop diuretics (39%), 17 (10%) thiazides...
January 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/27754186/sp-04-1-the-role-of-natriuretic-peptides-in-the-pathogenesis-of-cardiovascular-diseases
#13
Zhanna Kobalava
The burden of cardiovascular diseases (CVD) in general and heart failure (HF) in particular continues to increase worldwide. CVD are major contributors to death and morbidity and recognized as important drivers of healthcare expenditure. Chronic overactivity of the renin-angiotensin-aldosterone system (RAAS) plays a key role in human hypertension and HF pathophysiology. RAAS is fundamental in the overall regulation of cardiovascular homeostasis through the actions of hormones, which regulate vascular tone, and specifically blood pressure through vasoconstriction and renal sodium and water retention...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27754163/sy-11-3-hypertension-in-women-more-dangerous-than-in-men
#14
Suzanne Oparil
Heart disease, stroke, and kidney failure are leading causes of death worldwide, and hypertension is a significant risk factor for each. Hypertension is less common in women, compared to men, in those younger than 45 years of age. This trend is reversed in those 65 years and older. In the US between 2011-2014, the prevalence of hypertension in women and men by age group was 6% vs 8% (18-39 years), 30% vs 35% (40-59 years), and 67% vs 63% (60 years and over). Awareness, treatment, and control rates differ between genders with women being more aware of their diagnosis (85% vs 80%), more likely to take their medications (81% vs 71%) and more frequently having controlled hypertension (55% vs 49%)...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27643143/sp-04-1-the-role-of-natriuretic-peptides-in-the-pathogenesis-of-cardiovascular-diseases
#15
Zhanna Kobalava
The burden of cardiovascular diseases (CVD) in general and heart failure (HF) in particular continues to increase worldwide. CVD are major contributors to death and morbidity and recognized as important drivers of healthcare expenditure. Chronic overactivity of the renin-angiotensin-aldosterone system (RAAS) plays a key role in human hypertension and HF pathophysiology. RAAS is fundamental in the overall regulation of cardiovascular homeostasis through the actions of hormones, which regulate vascular tone, and specifically blood pressure through vasoconstriction and renal sodium and water retention...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27643118/sy-11-3-hypertension-in-women-more-dangerous-than-in-men
#16
Suzanne Oparil
Heart disease, stroke, and kidney failure are leading causes of death worldwide, and hypertension is a significant risk factor for each. Hypertension is less common in women, compared to men, in those younger than 45 years of age. This trend is reversed in those 65 years and older. In the US between 2011-2014, the prevalence of hypertension in women and men by age group was 6% vs 8% (18-39 years), 30% vs 35% (40-59 years), and 67% vs 63% (60 years and over). Awareness, treatment, and control rates differ between genders with women being more aware of their diagnosis (85% vs 80%), more likely to take their medications (81% vs 71%) and more frequently having controlled hypertension (55% vs 49%)...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27502849/long-term-changes-of-renal-function-in-relation-to-ace-inhibitor-angiotensin-receptor-blocker-dosing-in-patients-with-heart-failure-and-chronic-kidney-disease
#17
Hanna Fröhlich, Christoph Nelges, Tobias Täger, Vedat Schwenger, Rita Cebola, Johannes Schnorbach, Kevin M Goode, Syed Kazmi, Hugo A Katus, John G F Cleland, Andrew L Clark, Lutz Frankenstein
BACKGROUND: Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) have become cornerstones of therapy for chronic heart failure (CHF). Guidelines advise high target doses for ACEIs/ARBs, but fear of worsening renal function may limit dose titration in patients with concomitant chronic kidney disease (CKD). METHODS: In this retrospective observational study, we identified 722 consecutive patients with systolic CHF, stable CKD stage III/IV (estimated glomerular filtration rate [eGFR] 15-60 mL min(-1) 1...
August 2016: American Heart Journal
https://www.readbyqxmd.com/read/27347090/delayed-kidney-injury-following-coronary-angiography
#18
Feng Wang, Cheng Peng, Guangyuan Zhang, Qing Zhao, Changyou Xuan, Meng Wei, Niansong Wang
It is occasionally observed that patients without contrast-induced nephropathy (CIN) develop kidney injury within 1-6 months after coronary angiography (CAG), termed delayed CIN or delayed kidney injury (DKI) following CAG. The present study aimed to investigate the associated risk factors of delayed CIN and its possible pathogenesis. Subjects with CAG or coronary stenting from January 2008 to December 2009 were studied. A retrospective survey on DKI after CAG was conducted and the risk factors were analyzed...
July 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/27118234/soluble-guanylate-cyclase-stimulators-a-novel-treatment-option-for-heart-failure-associated-with-cardiorenal-syndromes
#19
REVIEW
Ruth F Dubin, Sanjiv J Shah
Heart failure in the setting of chronic kidney disease (CKD) is an increasingly common scenario and carries a poor prognosis. Clinicians lack tools for primary or secondary heart failure prevention in patients with cardiorenal syndromes. In patients without CKD, angiotensin-converting enzyme inhibitors (ACE-I) or angiotensin receptor blockers (ARB) and statins mitigate cardiovascular risk in large part due to salutary effects on the endothelium. In the setting of CKD, use of these therapies is limited by adverse effects of hyperkalemia in pre-dialysis CKD (ACE-I/ARB), or potential increased risk of stroke in end-stage renal disease (statins)...
June 2016: Current Heart Failure Reports
https://www.readbyqxmd.com/read/26705234/fixed-dose-combinations-of-renin-angiotensin-system-inhibitors-and-calcium-channel-blockers-in-the-treatment-of-hypertension-a-comparison-of-angiotensin-receptor-blockers-and-angiotensin-converting-enzyme-inhibitors
#20
COMPARATIVE STUDY
Fu-Chih Hsiao, Ying-Chang Tung, Shing-Hsien Chou, Lung-Sheng Wu, Chia-Pin Lin, Chun-Li Wang, Yu-Sheng Lin, Chee-Jen Chang, Pao-Hsien Chu
Fixed-dose combinations (FDCs) of different regimens are recommended in guidelines for the treatment of hypertension. However, clinical studies comparing FDCs of angiotensin receptor blocker (ARB)/calcium channel blocker (CCB) and angiotensin-converting enzyme inhibitor (ACE inhibitor)/CCB in hypertensive patients are lacking.Using a propensity score matching of 4:1 ratio, this retrospective claims database study compared 2 FDC regimens, ARB/CCB and ACE inhibitor/CCB, in treating hypertensive patients with no known atherosclerotic cardiovascular disease...
December 2015: Medicine (Baltimore)
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